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OST 575 Exam 3 Questions And 100% Correct Answers
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OST 575 Exam 3 Questions And 100% CorrectAnswers
Bare area of liver - ANSWER -Lies b/t two layers of the coronary ligament
-Devoid of peritoneum
-Important bc portacaval anastamosis potentially spreading infection from abdominal to
thoracic cavity
Blood supply of liver - ANSWER -Proper hepatic artery
-Hepatic portal vein
Common sites of fistula in intestines for fistula w/ gallbladder - ANSWER -Superior part
of duodenum
-Transverse colon
Cystic duct obstruction - ANSWER Causes pain but NO jaundice
Common bile duct obstruction - ANSWER Causes pain + jaundice + vomiting
Pain sensation of the foregut - ANSWER Greater splanchnic nn.
Aminotransferases - ANSWER -AST and ALT
-Transfer NH2 from a donor alpha-amino acid to an acceptor alpha-keto acid
-ALT is more specific for liver disease
-AST is more sensitive (higher quantity in liver)
,Albumin - ANSWER -Liver protein that functions as a transporter in blood for FFA's, Bile
acids, and Bile pigments
-*Decreased albumin leads to ascites:* Decreases osmotic pressure and leads to edema
Bilirubin - ANSWER -Formed by separation of heme from globin polypeptides
-Transported to liver for conjugation
-*Conjugated bilirubin is more water soluble*
Jaundice - ANSWER Deposition of bilirubin and yellowish coloration of skin, nail beds,
and sclerae due to hyperbilirubinemia
Players in Liver Function Tests - ANSWER 1) Aminotransferases
2) Serum proteins (Albumin)
3) Bilirubins
4) Blood clotting factors
Prothrombin time - ANSWER -How long it takes a plasma sample to clot after being
mixed w/ thromboplastin (Factor III) and calcium ions
-Reported as International Normalized Ratio (INR)
Activated partial thromboplastin time (aPTT) - ANSWER Time it takes plasma to clot
from the activation of Factor XII
Nonalcoholic Fatty Liver Disease (NAFLD) - ANSWER -Steatosis w/o ethanolism
-Most common cause of chronic liver injury
-Risk factors are obesity, T2DM, insulin resistance, metabolic syndrome
-Steatosis --> Steatohepatitis --> Steatofibrosis (*chicken wire fence/sinusoidal pattern*)
Steatofibrosis - ANSWER -Early on before cirrhosis develops, new collagen delicately
,encircles hepatocytes in a *chicken wire fence/sinusoidal pattern*
-Seen in NAFLD
Nonalcoholic Steatohepatitis (NASH) - ANSWER -Subset of NAFLD w/ *inflammation and
cellular injury*
-Pt's w/ *persistently elevated aminotransferases*
-Usually asymptomatic
Primary causes of NASH - ANSWER -Obesity
-Glucose intolerance
-T2DM
-Hypertriglyceridemia
-Low HDL
-HTN
One drink - ANSWER -12 oz beer / 5 oz wine / 1.5 oz spirits
-Delivers about 12 to 14 g of alcohol
NASH dx - ANSWER -Persistently elevated aminotransferase
-Fatty infiltrate on imaging
-Mallory bodies
-Dx best done w/ *liver biopsy*, however, don't do this in pt's w/ normal AST, ALT
NASH management - ANSWER -Directed at risk factors
-*Gradual* weight loss
What causes "Asian flush?" - ANSWER Asians have a deficiency of aldehyde
dehydrogenase, leading to decreased alcohol metabolism
, Drugs that are affected by alcohol consumption - ANSWER -Metronidazole
-Cimetidine
-Tricyclics
-Nitro, propanolol
-Morphine
-Acetaminophen
Fatty liver - ANSWER -Benign, usually seen in moderate drinkers and alcoholics
-Frequently asymptomatic, however, *hepatomegaly* is common
-AST > ALT; GGT elevation
-Tx: Abstinence. *Return to normal in 2-4 weeks*
Alcoholic hepatitis - ANSWER -Frequently precipitated by period of binge drinking
-Prodrome sx: anorexia, nausea, fatigue, weight loss
-May progress to cirrhosis over months to years
-*Increased AST/ALT ratio (2-3:1)*
-*Mallory bodies*
Findings commonly associated w/ advanced liver disease - ANSWER *1)
Hyperbilirubinemia*
-Icterus, jaundice
*2) Ascites*
-Due to portal HTN
*3) Increased systemic Estrogen*
-Gynecomastia
-Spider angiomata
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